Chance fracture

Flexion injury of the spine, leading to a compression injury to the anterior portion of the vertebral body and a transverse fracture through the posterior elements of the vertebra and the posterior portion of the vertebral body. It is caused by violent forward flexion, causing distraction injury to the posterior elements.

Most commonly at T12-L2. This fracture initially became known as a "seat belt injury" due to its association with the sudden forward flexion that occurs when one is involved in a head-on automobile collision while being restrained by a lap belt. With the advent of both lap and shoulder belts in the 1980s, Chance fractures have become less common.

Up to 50% of Chance fractures have associated intraabdominal injuries. Injures associated with Chance fractures include fractures of the pancreas; contusions or lacerations of the duodenum; and mesenteric contusions or lacerations.

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